Mental Health Support for LGBTQ Teens and Their Families

By Hector Rodriguez, MD, M.Div.

The Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) community includes a diverse range of people. One thing they share is a higher risk for mental health issues. Research shows that people identifying as lesbian, gay, or bisexual have twice the risk of having a mental health problem compared with heterosexual people. For transgender people, the risk for psychiatric issues is almost four times higher than cisgender individuals (those whose gender identity corresponds with the sex registered at birth). Because these issues are more common in the LGBTQ community, it’s important to know how to support them in the most effective ways.

UNDERSTAND GENDER IDENTITY AND SEXUAL ORIENTATION

Sexual orientation and gender identity are important facets in young people’s lives. Sexual orientation refers to a person’s emotional, sexual, and relational attraction to others, while gender identity denotes one’s inner sense of being female, male, or non-binary. As a young person develops into their teen years, it’s common to explore one’s sexuality and express identity as this is a time for self-discovery.

THE TEENAGE BRAIN’S ROLE IN SEXUALITY

The human brain isn’t fully matured until a person reaches their mid-to-late 20s. In particular, a process called myelination is still ongoing during this time. Myelination coats the brain’s nerve cells in a protective fatty sheath that accelerates cell communication. The process begins at the back bottom of the brain, which means the last brain region to benefit from myelination is the prefrontal cortex (PFC), an area involved in impulse control, decision-making, judgment, planning, forethought, follow-through, and executive functions.

Because the PFC is still developing, it makes teens more likely to be impulsive and engage in risky behaviors. Research shows that increased risk-taking in adolescents is also due to changes in the brain’s socio-emotional system, including heightened reward-seeking and changes in the dopaminergic system. The neurotransmitter dopamine is involved in motivation, and these changes make teens more motivated to seek rewarding experiences despite the risks.

Considering it’s also a time of sexual exploration and self-discovery, this can lead to some problems. Internet searches about sexuality may turn up misinformation that is harmful to self-esteem, direct young people to online pornography, or encourage the use of “hook-up apps.” These can open the door to high-risk behaviors and sexual situations for which a teen may not be fully prepared. After engaging in a risky rendezvous or viewing online porn, teens may feel ashamed, guilty, or, in some cases, traumatized.

WHEN TEENS FACE REJECTION DUE TO SEXUAL ORIENTATION OR GENDER IDENTITY

Teens who consider themselves part of the LGBTQ community—or who are questioning if they may be—are often hesitant to talk openly about it because they are afraid of being rejected by their family, friends, and classmates. According to the 2018 LGBTQ Youth Report, the largest survey of its kind involving more than 12,000 LGBTQ teens, these individuals experience heartbreakingly high levels of stress, anxiety, and fear. Some key findings from the report include:

• 95% of LGBTQ youth have difficulty sleeping
• Over 70% report feeling worthless or hopeless in the past seven days
• Only 26% say they always feel safe in the classroom, meaning nearly 75% don’t feel safe
• 67% say they have heard family members make negative remarks about LGBTQ individuals

Feeling excluded by peers can be devastating for adolescents. Research shows that younger people are less able to cope with exclusion than adults and find it more distressing. Rejection—real or perceived—can have major consequences, including increased risk for anxiety and depression, suicidal thoughts and behaviors, and homicidal thoughts and behaviors.

In addition, the added stress negatively impacts brain development. In fact, toxic stress can alter brain development in ways that affect thinking, learning, and memory, and that increases the risk of mental health issues and substance abuse. At Amen Clinics, brain SPECT imaging studies show that people in the LGBTQ community who have experienced rejection often have heightened activity in the basal ganglia, which is associated with anxiety.

SIGNS A TEEN MAY BE STRUGGLING WITH SEXUAL ORIENTATION OR GENDER IDENTITY

Due to fear of rejection, teens who are or think they may be LGBTQ don’t always share this with their parents or siblings. That’s why it’s important to know the signs that a teen may be struggling, such as:

• Self-isolation
• Increased irritability
• Avoiding family and friends
• Decreased communication with parents
• Pornography usage
• Use of hook-up apps
• Dressing in items or garments of another gender

Noticing these signs can give parents an opportunity to make a plan to support their teen.

HELPING LGBTQ TEENS FEEL SUPPORTED

If a teen is struggling with their sexual orientation or gender identity, it’s important for parents to create a home environment where the teen feels safe and supported. Having parental acceptance and family support reduces the rates of depressive symptoms, according to research. Other findings from the Trevor Project show that LGBTQ youth who have at least one adult who is accepting are 40% less likely to attempt suicide. This means that a parent’s acceptance can literally save a young person’s life in some cases.

Here are some strategies to make the home a safe space:

• Educate yourself and your family. Learn about the LGBTQ community, be aware of possible struggles, and be empathetic.
• Be open to talking. Don’t try to force a teen to open up about their sexual orientation or gender identity, but do let them know that you are available to listen without judgment.
• Let teens know they are loved. Letting a young person know that you support them and love them regardless of sexual orientation or gender identity can be very powerful for a teen’s self-esteem, confidence, and mental well-being.
• Be curious about their life. You don’t have to focus every conversation on sexual orientation or gender identity. Ask questions and talk to them about all aspects of their life to build a stronger relationship.
• Use inclusive language. Respect a teen’s wishes regarding the pronouns (he/him, she/her, they/them) and the name they want to use.
• Seek professional help. Talking with a mental health professional can be beneficial for parents and teens and can provide another safe environment to express emotions, fears, worries, and more. It can also be a critical part of coping with any mental health issues, such as anxiety, depression, suicidal ideation, or other issues.

Anxiety, depression, and other mental health issues that can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.